【摘 要】
：
BACKGROUND: Transmuscular tubular diskectomy has been introduced to increase the rate of recovery, although evidence is lacking.OBJECTIVE: To evaluate the 2-year results of tubular diskectomy compared
【机 构】
：
Medical Center Haaglanden The Netherlands
论文部分内容阅读
BACKGROUND: Transmuscular tubular diskectomy has been introduced to increase the rate of recovery, although evidence is lacking.OBJECTIVE: To evaluate the 2-year results of tubular diskectomy compared with conventional microdiskectomy.METHODS: Three hundred twenty-eight patients with persistent leg pain caused by lumbar disk herniation were randomly assigned to undergo tubular diskectomy (167 patients) or conventional microdiskectomy (161 patients).Main outcome measures were scores from Roland-Morris Disability Questionnaire for Sciatica, Visual Analog Scale for leg pain and low-back pain, and Likert selfrating scale of global perceived recovery.RESULTS: On the basis of intention-to-treat analysis, there was no significant difference between tubular diskectomy and conventional microdiskectomy in Roland-Morris Disability Questionnaire for Sciatica scores during 2 years after surgery (between-group mean difference (A =0.6; 95% confidence interval [CI], 20.3-1.6).Patients treated with tubular diskectomy reported more leg pain (A =3.3 mm; 95% CI, 0.2-6.2) and more low back pain (A =3.0 mm; 95% CI, 20.2-6.3) than those patients treated with conventional microdiskectomy.At 2 years, 71% of patients assigned to tubular diskectomy documented a good recovery vs 77% of patients assigned to conventional microdiskectomy (odds ratio, 0.76; 95% CI, 0.45-1.28; P =0.35).Repeated surgery rates within 2 years after tubular diskectomy and conventional microdiskectomy were 15% and 10%, respectively (P =0.22).CONCLUSION: Tubular diskectomy and conventional microdiskectomy resulted in similar functional and clinical outcomes.Patients treated with tubular diskectomy reported more leg pain and lowback pain, although the differences were small and not clinically relevant.
其他文献
Schizophrenia is a severe mental disorder that affects 1% of the population.One strategy to dissect the underlying genetic architecture and neurobiological substrate of schizophrenia is through the us
1.Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder in childhood and adulthood, often with coexisting conditions e.g.Substance Use Disorders (SUD).So far, there is no instrument tha
Major depression is a worldwide severe mental health problem where unfortunately not all depressed patients respond to the classical treatment algorithms.Some recent research suggests that intensive h
This case series highlights three patients with Parkinsons disease residing at nursing home facilities whose deep brain stimulators were accidentally deactivated for varying lengths of time, which was
iNPH is an important cause of dementia that needs more awareness.The purpose is to present data on the importance of the clinical symptomatology, the natural cause of the disorder, new data on supplem
Evidence has indicated an elevation of S I00B in CSF and serum from subarachnoid hemorrhage (SAH) patients.In a previous study, we found that: (1) S100B, and its receptor, the receptor for advanced gl
Chronic neuropathic pain is a common and debilitating consequence of spinal cord injury (SCI).In a rat contusion injury model, we observed that chronic neuropathic pain is present on day 7 after SCI a
Background: Alcohol addiction is characterized by cognitive impairments, such as a malfunctioning attentional control and response inhibition system.Alcohol dependent patients therefore have more diff
Background and Purpose: Intracerebral hemorrhage (ICH) causes 10-15% of all first-ever strokes with a 35-52% 30-day mortality.Blood pressure (BP) reduction may attenuate hematoma growth.The ACCELERATE
Long term potentiation (LTP) is the key cellular mechanism for physiological learning and pathological chronic pain.In case of persistent chronic pain, peripheral injury triggered LTP in the spinal co